Fluoroquinolones − a class of antibacterial drugs with a wide spectrum of activity and a high level of oral absorption, which are widely used in clinical practice.
At the same time, the frequency of reports of the development of certain adverse reactions from the use of these drugs has recently been growing.
Find out in the article on estet-portal.com what side effects can occur during antibiotic therapy using fluoroquinolones.
- Mechanism of side effects of fluoroquinolones
- Methodology and main results of the safety study of fluoroquinolones
- Practical significance and clinical perspectives of the use of fluoroquinolonesin
Mechanism of side effects of fluoroquinolones
According to studies, some of the side effects (eg, retinal detachment) are due to several factors.
Other adverse events, including aortic aneurysm and dissection, development of peripheral neuropathies and cardiac arrhythmias, are most correlated with previous use of fluoroquinol antibiotics.
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The proposed mechanism of development of such complications is associated with the proven in vitro ability of fluoroquinolones to initiate damage to connective tissue in general and collagen structures in particular.
Thus, a recent study reported a case of diagnosed aortic valve prolapse shortly after starting antibiotic therapy with ciprofloxacin for 2 days, with no other possible explanation for the development of this condition.
Like the connective tissue framework of the aorta, the basis of the extracellular matrix of the aortic and mitral valves is collagen fibers that provide the functionality of these structures.
Therefore, damage to the connective tissue leads to the development of valve prolapse and regurgitation.
For example, in patients with Marfan's syndrome, systemic connective tissue damage causes frequent development of heart valve prolapse, which can subsequently progress to severe forms of mitral regurgitation through rupture of the chords and lead to the development of cardiac insufficiency, and in some cases − sudden death.
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Clinical studies of complications of fluoroquinolones
Recent clinical studies provide new evidence that oral antibiotic therapy with fluoroquinolones, in particular ciprofloxacin, increases the risk of mitral and aortic regurgitation in patients by 2.4 times compared with those who were prescribed drugs of the penicillina group (amoxicillin).
It has been established that a high risk of developing these adverse effects is noted when using these drugs within 30 days from the date of antibiotic therapy.
Methodology and main results of the safety study of fluoroquinolones
Substantiating the relevance of the study, the authors pointed to the breadth of use of antimicrobial preparations of the fluoroquinol series.
To solve the tasks, the data of the notification system Food and Drug Administration's adverse reporting system , USA, about adverse reactions in connection with the appointment of fluoroquinolones were analyzed.
In addition, an assessment of the US private insurance claims database was performed, reflecting:
- demographic indicators;
- identification of medicines;
- intended dosage;
- Duration of treatment.
Recent drug exposure to was defined as use of fluoroquinolones within 31-60 days and 61-365 days prior to the date of reporting adverse effects.
The comparison was made with patients who were prescribed antibiotic therapy with groups of semisynthetic penicillins (amoxicillin) and macrolides (azithromycin).
As a result of the study, the risk of developing aortic and mitral regurgitation was found to be low when analyzing the long-term possible consequences of antibiotic therapy with fluoroquinolones in comparison with adverse reactions that can be recorded in the near future from the start of the prescribed therapy
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Practical significance and clinical prospects for the use of fluoroquinolonesSummarizing the data of the work carried out, the authors expressed the hope that similar results will be confirmed by
additional parallel studies.
This will allow us to reasonably talk about the risks of developingaortic and mitral regurgitation as potential side effects of the use of fluoroquinolones.
In addition, the researchers drew the attention of the target audience to the unequivocal importance ofa balanced approach to prescribing antibiotics, given the risks of undesirable consequences of their use.
The authors also expressed the hope that the results obtained may provide a convincing argument for clinicians to usealternative classes of antibacterial drugs as the first line of defense in the treatment of uncomplicated infectious diseases.
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